Licensed or certified Texas Health and Human Services (HHS) providers must notify the agency if someone in their care has been or may be physically or mentally abused, neglected or exploited.

Depending on their reporting guidelines and HHS rules, providers may be required to report other incidents including:

Deaths

Misappropriation of funds

Drug diversions

Missing persons

Injuries of unknown source

Fires

Situations that pose a threat to residents, employees or the public, including calling the police or the local fire authority to maintain safety

Self-reporting FAQs

How soon must an incident be reported?

Providers must make a report immediately upon learning of the incident, unless otherwise required by Regulatory Services reporting guidelines. See "Which incidents are reportable?" below for more information.

Where can I get help learning how to use the online report?

What happens when I call to make a report?

The following announcement plays when option 2 is selected from the main menu:

This option is not for the general public to report a complaint or request program information. Please re-dial and choose another option from the main menu. If you are reporting on behalf of a HHS provider, please continue.

To speak with an intake specialist between the hours of 7 a.m. to 7 p.m. Monday through Friday, press 1.

Once you select a script from the menu, you will begin to hear the incident form script. After each response, you will need to press the # key to move to the next query. It's important that you talk slowly and clearly and answer in complete sentences.

If information is not available at the time of the report or is not pertinent to the incident being reported, press the # key after the tone to move to the next query.

At the end of the script, you will be given an opportunity to provide additional information relevant to the incident report or to add to the information already recorded.

When you hang up, the report is submitted.

When can I report an incident?

Providers can make a report any time of day or night. HHS intake employees monitor the incident form application from 7 a.m. to 7 p.m. Central time, Monday through Friday.. On weekends and holidays, it is monitored from 8 a.m. — 5 p.m.

An intake specialist will call you to:

Obtain additional information

Clarify details

Give you the incident intake ID number which you will need to complete the Provider Investigation Report, HHS Form 3613 or 3613-A

What information do I need to report an incident?

You need to provide the following information in the initial report:

Your name and title.

Primary and secondary phone numbers, including area code, where you can be reached.

The name of the facility, home health or hospice agency on whose behalf you are making the report. Please include the facility ID number or home health or hospice agency license number.

Whether or not the incident was reported to the police or the Texas Department of Family and Protective Services (DFPS). Please include the name of the employee who made the report and the DFPS call ID reference number or the police report number.

The name, age, date of birth and Social Security number of the person about whom you are making the report. In addition, we need to know:

If special supervision was required

The person's level of cognition

The person's pertinent medical history

If there was a history of similar or prior incidents

The date and time you first learned of the incident and a brief narrative summary of the reportable incident. Please include the names of any alleged perpetrators or witnesses.

The date, time and results of any assessment conducted, including findings of injury or adverse effects noted.

Type of treatment provided, and when and where treatment was provided.

The immediate action taken to protect other people and to prevent occurrences of similar incidents while you conduct and complete your investigation.

The name(s) of anyone else you notified about the incident.

How soon must a facility complete a provider investigation report?

Note: The following applies to nursing facilities, skilled nursing facilities, day activity and health service providers, assisted living facilities, and intermediate care facilities (ICF/IIDs).